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Lawmakers
Finally Ready To Grapple With Looming Physician Pay CutsBut are they willing
to spend enough to prevent a 31-percent shortfall?

If you've
been holding your breath waiting for Congress to confront
the physician payment disaster on the horizon, then you
can exhale at last.

Lawmakers
finally considered the options for fixing the troubled physician
update formula at a Feb. 10 hearing of the House Ways and
Means Health Subcommittee. Subcommittee Chair Nancy Johnson
(R-CT) said she's in favor of paying physicians based on
their quality of care and asked physicians to come up with
suggestions for quality indicators.

"I
don't believe the old formula ... can be fixed," Johnson
said. "We need to fundamentally rethink the way we
pay our doctors." Congress rescued physicians from
potential cuts in 2004 and 2005 by mandating payment increases,
but didn't address the formula that called for cuts.

One
major problem with the current approach: "The best
and the worst providers receive the same reimbursement,"
Johnson said. Already, hospitals are receiving more payments
if they report quality measures related to information technology.
Now physicians need to step up to the plate and propose
their own quality indicators.

Even
with a congressional heavyweight like Johnson behind physician
payment reform, the issue faces an uphill struggle. Time
may be a scarce commodity with battles over Social Security
and federal spending on the way.

The
subcommittee's top-ranking Democrat, Rep. Fortney "Pete"
Stark (CA), said that revamping Medicare physician payment
is long overdue. Congress made the situation worse by putting
off a real fix, he said. But Stark seems less inclined than
Johnson to move quickly toward a pay-for-performance model.